Reporter's notebook: Why the middling CPAP compliance?

It's a number that's floated around the industry for years: a CPAP compliance rate stuck at an average of about 55%.

“I have people asking me all the time where that number comes from,” said Eric Cohen, president of Concord, N.H.-based National Sleep Therapy. “I don't know if it's anecdotal or came from some study in 2001 and people assume that it hasn't gotten any better.”

One factor could be how compliance is determined, say providers. For example, tracking straight usage of a CPAP device vs. tracking compliance to meet Medicare requirements with follow up visits and submitting required documentation.

Provider Lisa Feierstein has been monitoring compliance since before it was even a watchword and says it has paid off with compliance rates that hover in the 80% range.

“We always have been diligent about having a whole system and compliance team,” said Lisa Feierstein, co-founder and president of Raleigh, N.C.-based Active Healthcare, where compliance rates are in the 80% range. “Sadly, I think for many it really is in the 55% range and that's why we've gotten a lot of competition from physician and sleep labs who said they could do it better.”

That's been Cohen's experience.

“We go into hospital and labs that have called us in to say, 'hey we are unhappy with our DME company, can you do better,” he said.

Increased financial pressure combined with onerous documentation requirements could force even the most well-meaning provider to have to prioritize.

“I do think that there are many providers that provide CPAP equipment but don't have the proper staff or RTs to follow up, so that 55% may be correct,” said Ron Evans, owner of Phoenix-based Valley Respiratory Services. “Ours is much higher and always has been but I've always made that a priority.”

Prioritizing patient engagement can boost compliance rates, says provider John Eberhart who says his are in the 80% to 85% range.

“People stop by the store all the time,” said Eberhart, president of Farmington, N.M.-based Eberhart Home Health. “I have an RT in a little department there so it's a lot of face time, which is really helpful.”

At the end of the day, all the patient hand-holding in the world can't help certain patients, providers say.

“Some people don't naturally take to it, they don't understand it,” said Cohen. “A lot of it is about the education they are given when they are setup, but some people are just never gonna get it.”